• Open Access

Reorganization of Verbal and Nonverbal Memory in Temporal Lobe Epilepsy Due to Unilateral Hippocampal Sclerosis

Authors

  • H. W. Robert Powell,

    1. Department of Clinical and Experimental Epilepsy, Institute of Neurology, University College London, Queen Square, London; and MRI Unit, National Society for Epilepsy, Chalfont St. Peter, Bucks
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  • Mark P. Richardson,

    1. Department of Neurology, Institute of Psychiatry, Kings College London, London, United Kingdom
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  • Mark R. Symms,

    1. Department of Clinical and Experimental Epilepsy, Institute of Neurology, University College London, Queen Square, London; and MRI Unit, National Society for Epilepsy, Chalfont St. Peter, Bucks
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  • Philip A. Boulby,

    1. Department of Clinical and Experimental Epilepsy, Institute of Neurology, University College London, Queen Square, London; and MRI Unit, National Society for Epilepsy, Chalfont St. Peter, Bucks
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  • Pam J. Thompson,

    1. Department of Clinical and Experimental Epilepsy, Institute of Neurology, University College London, Queen Square, London; and MRI Unit, National Society for Epilepsy, Chalfont St. Peter, Bucks
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  • John S. Duncan,

    1. Department of Clinical and Experimental Epilepsy, Institute of Neurology, University College London, Queen Square, London; and MRI Unit, National Society for Epilepsy, Chalfont St. Peter, Bucks
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  • Matthias J. Koepp

    1. Department of Clinical and Experimental Epilepsy, Institute of Neurology, University College London, Queen Square, London; and MRI Unit, National Society for Epilepsy, Chalfont St. Peter, Bucks
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Address correspondence and reprint requests to Professor John Duncan, Department of Clinical and Experimental Epilepsy, National Hospital for Neurology and Neurosurgery, Queen Square, London, WC1N 3BG, U.K. E-mail: j.duncan@ion.ucl.ac.uk

Abstract

Summary: Purpose: Patients with temporal lobe epilepsy (TLE) due to hippocampal sclerosis (HS) often suffer from material-specific memory impairments. The purpose of this study was to use functional magnetic resonance imaging (fMRI) to study the organization of specific memory functions in these patients.

Methods: We report 14 patients with unilateral TLE and HS, and 10 controls, performing an fMRI memory paradigm of word, picture, and face encoding.

Results: Compared with controls, patients with left TLE demonstrated less left MTL and greater right MTL activation and patients with right TLE demonstrated less right MTL and greater left MTL activation. Correlations between fMRI activation and memory performance revealed greater activation in the damaged left hippocampus to be correlated with better verbal memory performance in left TLE patients and greater right hippocampal activation to be correlated with better nonverbal memory in right TLE patients. Conversely, greater fMRI activation in the contralateral hippocampus correlated with worse memory performance.

Conclusions: Our findings suggest that memory function in unilateral TLE is better when it is sustained by activation within the damaged hippocampus and that reorganization to the undamaged MTL is an inefficient process, incapable of preserving memory function.

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